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Associate Professor Ng Wai Hoe, Senior Consultant and Medical Director, Department of Neurosurgery, National Neuroscience Institute (NNI), a member of the SingHealth group, shares on the diagnosis and treatment of meningioma.

While meningiomas are benign, the tumour can grow to a relatively large size and pressed against the brain, causing headaches, blurred vision or even loss of memory.

How is meningioma diagnosed

Doctors can use a variety of tests to diagnose meningioma. These include a computed tomography (CT) scan and magnetic resonance imaging (MRI) scan. The scans will help determine the size, location and grade of the brain tumour.

Treatment of meningioma

  • Observation
    Small, slow-growing benign meningioma tumours without any significant symptoms may not require immediate treatment, especially in the elderly. Doctors will often recommend a period of watchful waiting and periodic brain scans to monitor any signs of tumour growth.
  • Surgery
    The majority of meningiomas can be treated with surgery.

    "Meningioma tumours can generally be removed if they are located near the brain’s surface and have not invaded any critical structures such as the optic nerve and brain stem," says Associate Professor Ng.

  •  Some tumours, however, can only be partially removed because they are near important brain structures. In this case, surgery is followed by radiation therapy. There will be periodic brain scans to monitor any recurrence of the brain tumour.

    Steroids are often given to reduce brain swelling before and after the operation. Some patients may develop seizures after surgery, so anti-convulsants may be prescribed before and after surgery to prevent seizures.

    Others may experience temporary muscle weakness, speech and coordination problems. Physical, occupational and speech therapy will help should these complications occur.
  • Radiation therapy or radiosurgery
    If the meningioma is malignant, is not suitable for surgery or can only be partially removed by surgery, radiation therapy will be considered.

    Radiation therapy is used to destroy the meningioma cells, shrink the tumour or prevent it from growing bigger.

    In small meningiomas, stereotactic radiosurgery using the Novalis shaped-beam surgery system is the preferred method. It allows delivery of a high dose of radiation directly to the brain tumour with no or minimal damage to surrounding brain structures.

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